先天性甲状腺减低症形态学变化与相关病因探讨

Explore on morphologic changes and related factors in congeital hypothyroidism.

【目的】 探讨儿童先天性甲状腺功能减低症(简称先天性甲低)甲状腺形态学改变与相关病因、症状轻重、疗效和预后判断之间的关系,对临床诊治及判断预后提供依据。 【方法】 对40 例先天性甲低患儿进行了二维及彩色多普勒检查,其中8例进行同位素扫描,所有患儿均经化学发光免疫分析法检测T3、T4、TSH。 【结果】 40例先天性甲低患儿中甲状腺发育不良14例(35%),甲状腺缺如8例(20%) ,甲状腺增大6 例(15%),甲状腺囊性变5例(12.5%),甲状腺异位4例(10.5%),甲状腺正常3例(7.5%)。甲状腺缺如患儿血浆T3、T4 水平[(0.52±0.13,25.82±4.08)nmol/L]明显低于甲状腺囊性变患儿血浆水平[(1.14±0. 23, 44. 44±15. 49) nmol/L],而血浆TSH(113.58±33.27)mU/L明显高于甲状腺囊性变患儿(30.23±12.48)mU/L。甲状腺发育不良和甲状腺异位患儿血浆T3、T4 和TSH水平与甲状腺缺如患儿间差异无显著性。 【结论】 了解先天性甲低形态学改变对探讨相关病因、临床症状、疗效和预后判断有较重要的临床意义。

【Objective】To study the thyroid morphologic changes and the related factors ,symptom degree,curative effect and prognosis in congeital hypothyroidism (CH) of children. Two-dimensional and color Deppler ultrasound examinations were performed on 40 cases and 8 of these casas were scaned by isotope. T_3、T_4、thyroid stimulating hormone (TSH) of all the patients were tested by chemiluminescence. Among the 40 cases , 14(35%) was thyroid gland dysplasia,8 (20%)was thyroid absence,6(15%) was enlargement of thyroid, 5(12.5%) was capsula glandulae thyroideae,4(10.5%)was thyroid ectopy and 3(7.5%) was nomal thyroid gland. T_3、T_4 plasma levels (0.52±0.13, 25.82±4.08) of the thyroid absence patients were evidently lower than the level (1.14±0.23, 44.44±15.49) of the capsula glandulae thyroideae patients, and plasma TSH [(113.58±33.27)mU/L] was evidently higher than the capsula glandulae thyroideae [(30.23±12.48)mU/L] patients. T_3、T_4 and TSH levels of the thyroid gland dysplasia and thyroid ectopy patients hadn’t great difference with the thyroid absence patients. [Conclusion] Understanding morphologic changes of CH has great significance on the exploration of relative factors, clinical phenotype,effect and prognosis.